ACA Celebrates Sixth Anniversary

On the sixth anniversary of the Affordable Care Act (ACA), the U.S. Department of Health and Human Services (HHS) announced that Medicare spent $473 billion less between 2009 and 2014 than the program would have if pre-ACA cost-growth trends had continued. HHS attributed this success to the law’s focus on paying for quality of care rather than volume of procedures performed, and used this anniversary to tout other successes of the law.

New CBO Report on Health Care Spending

According to a recently released Congressional Budget Office (CBO) report, the projected cost of the Affordable Care Act’s (ACA) insurance coverage provisions has grown by $136 billion over the 2016-2025 period compared to last year’s estimate. This 11 percent increase can be accounted for due to spending on increased Medicaid enrollment and the postponement of the “Cadillac tax” on high-cost insurance plans. While the agency increased its estimates for Medicaid enrollment, it lowered its projections for exchange enrollment by approximately 1 million people. Twelve million are expected to have coverage through the exchanges by the end of the calendar year, with 19 million people enrolled by 2025. Medicaid enrollment is expected to grow to 69 million in this time period, at which point Medicaid and the Children’s Health Insurance Program (CHIP) will cover one in four people under age 65. CBO estimates that 24 million more people will have insurance coverage in 2026 than if the law had not been enacted. And the total cost of the health care law is still less than expected when the ACA was first approved. Since its passage, the price of the ACA has declined by approximately 25 percent, to $157 billion. CBO announced that it would no longer project separate costs of the law’s insurance coverage provisions, such as exchange subsidies and Medicaid expansion, in order to present a fuller picture of the law’s impact on insurance coverage.

GAO Examines Healthcare.gov Security

A Government Accountability Office (GAO) report was released last week indicating that Healthcare.gov logged 316 cybersecurity incidents during an 18-month period. While none of the incidents resulted in the compromise of sensitive information, GAO did outline a number of failures on the part Centers for Medicare and Medicaid Services (CMS) to protect the website’s data hub. The data hub is responsible for sending personal data to various federal agencies for the purposes of verification. The GAO found that CMS did not consistently patch security flaws, sufficiently restrict administrator privileges, or adequately monitor security controls in state-based marketplaces, while also using an insecure configuration of the network.

Upcoming Congressional Meetings and Hearings

POSTPONED: Senate Finance Committee markup to vote on the nomination of Mary Katherine Wakefield to be deputy HHS secretary; time and place TBD

Senate Health, Education, Labor and Pensions Committee final markup on innovation agenda; time and place TBA; April 6

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 -  2018